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Neck Muscles and CSM– An Update Part 2 of 2

Neck Muscles and CSM– An Update Part 2 of 2

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By Timothy Boerger
Reviewed by B.Davies

Neck Muscles and CSM– An Update Part 2 of 2
This second of a 2-part mini-series on the properties of muscles in the neck and how they impact outcomes of surgery. We previously looked at this following an early piece of research from North America.  This series will serve as an update on this research.

Why was this study conducted?
For a short recap of the previous 2 blogs related to this: how much fat there is within muscles has been related to symptoms of myelopathy. Additionally, cervical lordosis, or, the curve of the neck, is believed to be related to outcomes following laminoplasty.1 

How was the study conducted?
This study performed a pre-operative MRI at which they performed measurements of the neck muscles. They then tracked the participants for 12 months post cervical laminoplasty to assess the curvature of the neck with x-ray.

What was discovered?
The main finding was that muscle size at multiple vertebral levels in the neck is related to loss of curve following surgery. The smaller the neck muscle size, the greater loss of neck curve.

Why is this important?
This is further evidence suggesting the muscles in your neck are important in myelopathy.  It should be noted that this study only looked at patients who underwent a laminoplasty, one of many different types of surgical procedure for myelopathy (i.e. it is unclear whether this finding would be applicable to other types of surgery such as ACDF).
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Whilst this link is again being drawn, it remains to be seen whether or not treatments to help neck musculature could make a difference to patients.  The authors in this study suggest it could better advise on the type of surgery that is to be performed.  Drilling down to these questions will be an important next step for this line of research. 

Have you had any therapy to strengthen your neck pre- or post- surgery? Did it help?
    
Reference
Lee BJ et al. Importance of the Preoperative Cross-Sectional Area of the Semispinalis Cervicis as a Risk Factor for Loss of Lordosis after Laminoplasty in Patients with Cervical Spondylotic Myelopathy. Euro Spine J. epub 2018: 1-10


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